Tag: reimbursement rates

On November 7, voters elected nomineePhil Murphy to serve as the state’s 56th Governor starting this January through 2022. Governor-elect Murphy chose Assemblywoman Sheila Oliver to serve as Lieutenant Governor. Assemblywoman Oliver served as Speaker of the Assembly for four years. All 120 of the legislative seats were also up for election. The democrats increased their majorities in both houses where they will control the Senate 25-15, and the Assembly 52-28. BAYADA is looking forward to the new administration to support home health care and help us deal with the many challenges of managed Medicaid, access to care, and increasing wages for our field staff through higher reimbursement under Medicaid and waiver programs.

I had the pleasure of hosting Carol Murphy, Assembly candidate in Legislative District 7, for a home visit to meet my daughter Mary. As a 20 year long client of Mt. Laurel Pediatrics (MLP), Mary is the epitome of what home care can help families to achieve and we wanted Ms. Murphy to experience that first-hand. Clinical Manager Chantel Denny and Administrative Coordinator Brooke Fitzpatrick discussed some of the challenging staffing issues that occur due to low reimbursement rates and difficulty attracting qualified nurses. Registered Nurse Stacey Sutton shared some of the varied tasks that she performs in order to keep Mary healthy and safe at home and at school. Ms. Murphy made a commitment, if elected to work with us to make home health care nursing a more attractive career option in the state.

District 6 Assemblywoman Pamela Lampitt got quite an education when she visited with 14 year old Mt. Laurel Pediatrics (MLP) client Juan M and his mother, Carmen. The Assemblywoman stopped by the house at the same time as nurse Danielle Blackwas administering Juan’s many respiratory treatments. MLP Clinical Manager Crystal Lee explained to Assemblywoman Lampitt the purpose behind each piece of equipment and treatment and how important the routine is to maintaining Juan’s health. The client’s mother Carmen said she is a single-parent and without having nursing in place she would not be able to keep her son at home with her. Carmen, Crystal, and Client Services Manager Michelle Moran took turns sharing the difficulties of staffing such a high-tech case and how low reimbursement rates negatively affect clients. Carmen shared with the Assemblywoman that she is currently looking for a part-time position but is having difficulty due to the fact that her schedule needs to remain flexible to accommodate the nursing schedule and Juan’s various medical needs. The visit was a great success in enlightening Assemblywoman Lampitt on the needs of some of her most vulnerable constituents.

We worked together and made it possible. After many years of advocating for higher reimbursement rates within the state Medicaid programs, we finally received an increase in the hourly rate for personal care services (PCS). This achievement was made possible through the persistent advocacy efforts of our employees, clients, families, and government affairs team. Our Hearts for Home Care Advocates participated in email campaigns, home visits, legislative roundtables, home care lobby days in Raleigh, and professional lobbying efforts.

As a result of working together, this week assistive care state programs directors throughout the state were thrilled to pass along an increase to our deserving CNAs and HHAs who care for our Medicaid clients and have stuck with us through thick and thin.

Directors have been personally speaking to staff to share the great news. “One by one, as I spoke to our aides, I heard the same thing – gratitude, appreciation, tears of joy, and, yes relief, too,” said Mimosa (MIM) Division Director Joe Seidel. “The low Medicaid reimbursement rate made it impossible to pay more. I am glad to do it now.” This rate increase is a good place to start, and more needs to be done.

Let’s keep the momentum going by joining to be a Hearts for Home Care Advocate. We believe our aides deserve even more for the important work they do in keeping our clients safe at home. If you are not already part of our advocacy group, join today at heartsforhomecare.com to receive alerts that could influence future efforts to increase pay rates.

The Boston Globe recently published a touching and impactful article detailing the plight of Noelia Ferreira and her fifteen-year-old daughter, Abi. The article detailed Noelia’s painful balancing act between being Abi’s mother and her nurse, and the anxiety she feels knowing that someone better trained should be taking care of Abi’s medical needs. While Abi qualifies for the care that would give Noelia a much needed sense of relief and reassurance, MA does not currently offer funding that attracts the qualified nurses necessary to provide the kind of care Abi needs. Noelia is not looking for any special consideration; she only wants the care that the state has already approved, care she has gone without for more than 150 days. (See the full Globe article here).

The lack of available medical professionals in MA is being felt by more than just the Ferreira’s. The abysmal reimbursement rates in the state leave providers with no means of meeting the care needs of the 900 people who need care in MA. Without an increase in the rates, families like Noelia’s will continue to go without the care they so desperately need. You can all help in the effort to get that increase. Go to mychildcantwait.com and tell Governor Baker to fund the critical CSN program!

As we continue on our PCA journey for increased reimbursement rates, the next effort to increase the PCA reimbursement rate now sits on the governor’s desk. A320/S1018 would require the minimum reimbursement rate for PCA in managed Medicaid to be no lower than the state’s fee-for-service rate. Currently, we are asking all the PCA aides and clients to sign and send letters to the governor’s office, urging him to sign the legislation into law.

Recently, Community Liaison and 2016 BAYADA Ambassador of the Year Mike Sokoloski hosted a roundtable with PA Representative Aaron Kaufer. BAYADA started building a relationship with Representative Kaufer before he was elected to the General Assembly. As a result of our relationship, Representative Kaufer took an interest in our issues early on and learned more about the state’s human services programs.

During the roundtable, we spoke about our need for increased reimbursement rates for personal assistant services under the Office of Long-Term Living and the need to equalize access to home and community based service by allowing presumptive eligibility*. Equalizing access was an issue of great interest to Representative Kaufer, and since the roundtable, the Government Affairs Office (GAO) has been in touch with the Representative multiple times to determine next steps in the process.

GAO looks forward to working with Representative Kaufer and others to ensure presumptive eligibility is allowed for home health care in the state.

*Presumptive eligibility: Individuals can be presumed eligible for Medicaid services while their full application is being processed. Presumptive eligibility grants greater access to care and allows the individual to receive medically necessary treatment.